The era of minimally invasive vitreous surgery: new insights into diabetic retinopathy surgery_Chinese Journal of Ocular Fundus Diseases

Authors：

 Lyu Lin , Chen Shida

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China;

Corresponding author：

Lyu Lin, Email: Lulin888@126.com

Keywords：

Diabetic retinopathy; Vitrectomy; Surgical procedures, minimally invasive; Editorial

DOI：

10.3760/cma.j.cn511434-20211206-00681

Video：

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Abstract Full text Figures/Tables Video References Cited by

Vitrectomy is the preferred surgical method for diabetic retinopathy, especially in the stage of proliferative diabetic retinopathy. Vitrectomy for diabetic retinopathy involves all aspects of vitrectomy, which is one of the signs of maturity of retinal surgeons. With the application of minimally invasive vitrectomy and perioperative anti-neovascularization drugs, indications and timing of surgery, perioperative medication, management of vitreous, and whether combined with cataract surgery have changed greatly, and new understanding is needed. Evidence-based clinical research on the timing of diabetic retinopathy surgery and perioperative drug use should be carried out to provide a new theoretical basis for the surgical treatment of diabetic retinopathy.

Citation： Lyu Lin, Chen Shida. The era of minimally invasive vitreous surgery: new insights into diabetic retinopathy surgery. Chinese Journal of Ocular Fundus Diseases, 2022, 38(1): 1-5. doi: 10.3760/cma.j.cn511434-20211206-00681 Copy

1.	Teo ZL, Tham YC, Yu M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis[J]. Ophthalmology, 2021, 128(11): 1580-1591. DOI: 10.1016/j.ophtha.2021.04.027.
2.	Song P, Yu J, Chan KY, et al. Prevalence, risk factors and burden of diabetic retinopathy in China: a systematic review and meta-analysis[J/OL]. J Glob Health, 2018, 8(1): 010803[2018-06-09]. https://pubmed.ncbi.nlm.nih.gov/29899983/. DOI: 10.7189/jogh.08.010803.
3.	American Society of Retina Specialists. Preferences and trends survey 2018[M]. Chicago, IL. , 2018.
4.	Mandelcorn M, Machemer R. Vitrectomy in the treatment os severe diabetic retinopathy, with follow-up[J]. Mod Probl Ophthalmol, 1975, 15: 226.
5.	Michels RG. Vitrectomy for complications of diabetic retinopathy[J]. Arch Ophthalmol, 1978, 96(2): 237-246. DOI: 10.1001/archopht.1978.03910050105001.
6.	Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized trial. Diabetic retinopathy vitrectomy study report 2. The Diabetic Retinopathy Vitrectomy Study Research Group[J]. Arch Ophthalmol, 1985, 103(11): 1644-1652. DOI: 10.1001/archopht.1985.01050110038020.
7.	El Annan J, Carvounis PE. Current management of vitreous hemorrhage due to proliferative diabetic retinopathy[J]. Int Ophthalmol Clin, 2014, 54(2): 141-153. DOI: 10.1097/IIO.0000000000000027.
8.	Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial-diabetic retinopathy vitrectomy study report 3. The Diabetic Retinopathy Vitrectomy Study Research Group[J]. Ophthalmology, 1988, 95(10): 1307-1320. DOI: 10.1016/s0161-6420(88)33015-0.
9.	Abdelhadi AM, Helaly HA, Abuelkeir A. Evaluation of retinal detachment after diabetic vitrectomy: causes and ways of management[J]. Clin Ophthalmol, 2020, 14: 53-60. DOI: 10.2147/OPTH.S235757.
10.	Storey PP, Ter-Zakarian A, Philander SA, et al. Visual and anatomical outcomes after diabetic traction and traction-rhegmatogenous retinal detachment repair[J]. Retina, 2018, 38(10): 1913-1919. DOI: 10.1097/IAE.0000000000001793.
11.	Lin J, Chang JS, Yannuzzi NA, et al. Cost evaluation of early vitrectomy versus panretinal photocoagulation and intravitreal ranibizumab for proliferative diabetic retinopathy[J]. Ophthalmology, 2018, 125(9): 1393-1400. DOI: 10.1016/j.ophtha.2018.02.038.
12.	Nawaz IM, Rezzola S, Cancarini A, et al. Human vitreous in proliferative diabetic retinopathy: characterization and translational implications[J/OL]. Prog Retin Eye Res, 2019, 72: 100756[2019-04-02].https://pubmed.ncbi.nlm.nih.gov/30951889/. DOI: 10.1016/j.preteyeres.2019.03.002.
13.	Muqit MM, Stanga PE. Swept-source optical coherence tomography imaging of the cortical vitreous and the vitreoretinal interface in proliferative diabetic retinopathy: assessment of vitreoschisis, neovascularisation and the internal limiting membrane[J]. Br J Ophthalmol, 2014, 98(7): 994-997. DOI: 10.1136/bjophthalmol-2013-304452.
14.	Ono R, Kakehashi A, Yamagami H, et al. Prospective assessment of proliferative diabetic retinopathy with observations of posterior vitreous detachment[J]. Int Ophthalmol, 2005, 26(1-2): 15-19. DOI: 10.1007/s10792-005-5389-2.
15.	Berrocal MH, Acaba-Berrocal L. Early pars plana vitrectomy for proliferative diabetic retinopathy: update and review of current literature[J]. Curr Opin Ophthalmol, 2021, 32(3): 203-208. DOI: 10.1097/ICU.0000000000000760.
16.	Zheng W, Chen S, Ding X, et al. Microinvasive pars plana vitrectomy versus panretinal photocoagulation in the treatment of severe non-proliferative diabetic retinopathy (the VIP study): study protocol for a randomised controlled trial[J/OL]. BMJ Open, 2021, 11(2): e043371[2021-02-22].https://pubmed.ncbi.nlm.nih.gov/33619191/. DOI: 10.1136/bmjopen-2020-043371.
17.	颜华, 崔靖, 于金国, 等. 增生性糖尿病视网膜病变患者玻璃体内血管内皮生长因子的表达[J]. 中华眼科杂志, 2009, 45(3): 206-209. DOI: 10.3760/cma.j.issn.0412-4081.2009.03.004.Yan H, Cui J, Yu JJ, et al. The expression of vascular endothelial growth factor of vitreous in patients with proliferative diabetic retinopathy[J]. Chin J Ophthalmol, 2009, 45(3): 206-209. DOI: 10.3760/cma.j.issn.0412-4081.2009.03.004.
18.	Berrocal MH, Acaba LA, Chenworth ML. Surgical innovations in the treatment of diabetic macular edema and diabetic retinopathy[J]. Curr Diab Rep, 2019, 19(10): 106. DOI: 10.1007/s11892-019-1210-x.
19.	Hagenau F, Vogt D, Ziada J, et al. Vitrectomy for diabetic macular edema: optical coherence tomography criteria and pathology of the vitreomacular interface[J]. Am J Ophthalmol, 2019, 200: 34-46. DOI: 10.1016/j.ajo.2018.12.004.
20.	Stolba U, Binder S, Gruber D, et al. Vitrectomy for persistent diffuse diabetic macular edema[J]. Am J Ophthalmol, 2005, 140(2): 295-301. DOI: 10.1016/j.ajo.2005.03.045.
21.	Jackson TL, Nicod E, Angelis A, et al. Pars plana vitrctomy for diabetic macular eddema: a systematic review, meta-analysis, and synthesis of safety literature[J]. Retina, 2017, 37(5): 886-895. DOI: 10.1097/IAE.0000000000001280.
22.	Simunovic MP, Hunyor AP, Ho IV. Vitrectomy for diabetic macular edema: a systematic review and meta-analysis[J]. Can J Ophthalmol, 2014, 49(2): 188-195. DOI: 10.1016/j.jcjo.2013.11.012.
23.	Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control[J]. Diabetes Care, 2009, 32(6): 1119-1131. DOI: 10.2337/dc09-9029.
24.	Crabtree GS, Chang JS. Management of complications and vision loss from proliferative diabetic retinopathy[J]. Curr Diab Rep, 2021, 21(9): 33. DOI: 10.1007/s11892-021-01396-2.
25.	Wang DY, Zhao XY, Zhang WF, et al. Perioperative anti-vascular endothelial growth factor agents treatment in patients undergoing vitrectomy for complicated proliferative diabetic retinopathy: a network meta-analysis[J/OL]. Sci Rep, 2020, 10(1): 18880[2020-11-03]. https://pubmed.ncbi.nlm.nih.gov/33144606/. DOI: 10.1038/s41598-020-75896-8.
26.	Tan Y, Fukutomi A, Sun MT, et al. Anti-VEGF crunch syndrome in proliferative diabetic retinopathy: a review[J]. Surv Ophthalmol, 2021, 66(6): 926-932. DOI: 10.1016/j.survophthal.2021.03.001.
27.	El-Sabagh HA, Abdelghaffar W, Labib AM, et al. Preoperative intravitreal bevacizumab use as an adjuvant to diabetic vitrectomy: histopathologic findings and clinical implications[J]. Ophthalmology, 2011, 118(4): 636-641. DOI: 10.1016/j.ophtha.2010.08.038.
28.	Van Geest RJ, Lesnik-Oberstein SY, Tan HS, et al. A shift in the balance of vascular endothelial growth factor and connective tissue growth factor by bevacizumab causes the angiofibrotic switch in proliferative diabetic retinopathy[J]. Br J Ophthalmol, 2012, 96(4): 587-590. DOI: 10.1136/bjophthalmol-2011-301005.
29.	Smith JM, Steel DH. Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy[J/OL]. Cochrane Database Syst Rev, 2015, 2015(8): CD008214[2015-08-07]. https://pubmed.ncbi.nlm.nih.gov/26250103/. DOI: 10.1002/14651858.CD008214.pub3.
30.	Jiang T, Gu J, Zhang P, et al. The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study[J]. BMC Ophthalmol, 2020, 20(1): 43. DOI: 10.1186/s12886-020-1321-9.
31.	Tang J, Kern TS. Inflammation in diabetic retinopathy[J]. Prog Retin Eye Res, 2011, 30(5): 343-358. DOI: 10.1016/j.preteyeres.2011.05.002.
32.	Das A, McGuire PG, Rangasamy S. Diabetic macular edema: pathophysiology and novel therapeutic targets[J]. Ophthalmology, 2015, 122(7): 1375-1394. DOI: 10.1016/j.ophtha.2015.03.024.
33.	Iglicki M, Zur D, Busch C, et al. Progression of diabetic retinopathy severity after treatment with dexamethasone implant: a 24-month cohort study the 'DR-Pro-DEX Study'[J]. Acta Diabetol, 2018, 55(6): 541-547. DOI: 10.1007/s00592-018-1117-z.
34.	Wykoff CC, Chakravarthy U, Campochiaro PA, et al. Long-term effects of intravitreal 0.19 mg fluocinolone acetonide implant on progression and regression of diabetic retinopathy[J]. Ophthalmology, 2017, 124(4): 440-449. DOI: 10.1016/j.ophtha.2016.11.034.
35.	Iglicki M, Zur D, Fung A, et al. Tractional diabetic retinal detachment surgery with co-adjuvant intravitreal dexamethasone implant: the tradition study[J]. Acta Diabetol, 2019, 56(10): 1141-1147. DOI: 10.1007/s00592-019-01357-y.
36.	Wong TY, Sun J, Kawasaki R, et al. Guidelines on diabetic eye care: the international council of ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings[J]. Ophthalmology, 2018, 125(10): 1608-1622. DOI: 10.1016/j.ophtha.2018.04.007.
37.	中华医学会眼科学分会白内障及人工晶状体学组. 中国糖尿病患者白内障围手术期管理策略专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.Cataract and Intraocular Lens Group of Ophthalmology Branch of Chinese Medical Association. Expert consensus on perioperative management strategies for cataract in diabetic patients in China (2020)[J]. Chin J Ophthalmol, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.
38.	Peterson SR, Silva PA, Murtha TJ, et al. Cataract surgery in patients with diabetes: management strategies[J]. Semin Ophthalmol, 2018, 33(1): 75-82. DOI: 10.1080/08820538.2017.1353817.
39.	Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology[J]. Am J Ophthalmol, 2003, 135(3): 291-296. DOI: 10.1016/s0002-9394(02)01972-4.
40.	Schiff WM, Barile GR, Hwang JC, et al. Diabetic vitrectomy: influence of lens status upon anatomic and visual outcomes[J]. Ophthalmology, 2007, 114(3): 544-550. DOI: 10.1016/j.ophtha.2006.08.017.

1. Teo ZL, Tham YC, Yu M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis[J]. Ophthalmology, 2021, 128(11): 1580-1591. DOI: 10.1016/j.ophtha.2021.04.027.
2. Song P, Yu J, Chan KY, et al. Prevalence, risk factors and burden of diabetic retinopathy in China: a systematic review and meta-analysis[J/OL]. J Glob Health, 2018, 8(1): 010803[2018-06-09]. https://pubmed.ncbi.nlm.nih.gov/29899983/. DOI: 10.7189/jogh.08.010803.
3. American Society of Retina Specialists. Preferences and trends survey 2018[M]. Chicago, IL. , 2018.
4. Mandelcorn M, Machemer R. Vitrectomy in the treatment os severe diabetic retinopathy, with follow-up[J]. Mod Probl Ophthalmol, 1975, 15: 226.
5. Michels RG. Vitrectomy for complications of diabetic retinopathy[J]. Arch Ophthalmol, 1978, 96(2): 237-246. DOI: 10.1001/archopht.1978.03910050105001.
6. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized trial. Diabetic retinopathy vitrectomy study report 2. The Diabetic Retinopathy Vitrectomy Study Research Group[J]. Arch Ophthalmol, 1985, 103(11): 1644-1652. DOI: 10.1001/archopht.1985.01050110038020.
7. El Annan J, Carvounis PE. Current management of vitreous hemorrhage due to proliferative diabetic retinopathy[J]. Int Ophthalmol Clin, 2014, 54(2): 141-153. DOI: 10.1097/IIO.0000000000000027.
8. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial-diabetic retinopathy vitrectomy study report 3. The Diabetic Retinopathy Vitrectomy Study Research Group[J]. Ophthalmology, 1988, 95(10): 1307-1320. DOI: 10.1016/s0161-6420(88)33015-0.
9. Abdelhadi AM, Helaly HA, Abuelkeir A. Evaluation of retinal detachment after diabetic vitrectomy: causes and ways of management[J]. Clin Ophthalmol, 2020, 14: 53-60. DOI: 10.2147/OPTH.S235757.
10. Storey PP, Ter-Zakarian A, Philander SA, et al. Visual and anatomical outcomes after diabetic traction and traction-rhegmatogenous retinal detachment repair[J]. Retina, 2018, 38(10): 1913-1919. DOI: 10.1097/IAE.0000000000001793.
11. Lin J, Chang JS, Yannuzzi NA, et al. Cost evaluation of early vitrectomy versus panretinal photocoagulation and intravitreal ranibizumab for proliferative diabetic retinopathy[J]. Ophthalmology, 2018, 125(9): 1393-1400. DOI: 10.1016/j.ophtha.2018.02.038.
12. Nawaz IM, Rezzola S, Cancarini A, et al. Human vitreous in proliferative diabetic retinopathy: characterization and translational implications[J/OL]. Prog Retin Eye Res, 2019, 72: 100756[2019-04-02].https://pubmed.ncbi.nlm.nih.gov/30951889/. DOI: 10.1016/j.preteyeres.2019.03.002.
13. Muqit MM, Stanga PE. Swept-source optical coherence tomography imaging of the cortical vitreous and the vitreoretinal interface in proliferative diabetic retinopathy: assessment of vitreoschisis, neovascularisation and the internal limiting membrane[J]. Br J Ophthalmol, 2014, 98(7): 994-997. DOI: 10.1136/bjophthalmol-2013-304452.
14. Ono R, Kakehashi A, Yamagami H, et al. Prospective assessment of proliferative diabetic retinopathy with observations of posterior vitreous detachment[J]. Int Ophthalmol, 2005, 26(1-2): 15-19. DOI: 10.1007/s10792-005-5389-2.
15. Berrocal MH, Acaba-Berrocal L. Early pars plana vitrectomy for proliferative diabetic retinopathy: update and review of current literature[J]. Curr Opin Ophthalmol, 2021, 32(3): 203-208. DOI: 10.1097/ICU.0000000000000760.
16. Zheng W, Chen S, Ding X, et al. Microinvasive pars plana vitrectomy versus panretinal photocoagulation in the treatment of severe non-proliferative diabetic retinopathy (the VIP study): study protocol for a randomised controlled trial[J/OL]. BMJ Open, 2021, 11(2): e043371[2021-02-22].https://pubmed.ncbi.nlm.nih.gov/33619191/. DOI: 10.1136/bmjopen-2020-043371.
17. 颜华, 崔靖, 于金国, 等. 增生性糖尿病视网膜病变患者玻璃体内血管内皮生长因子的表达[J]. 中华眼科杂志, 2009, 45(3): 206-209. DOI: 10.3760/cma.j.issn.0412-4081.2009.03.004.Yan H, Cui J, Yu JJ, et al. The expression of vascular endothelial growth factor of vitreous in patients with proliferative diabetic retinopathy[J]. Chin J Ophthalmol, 2009, 45(3): 206-209. DOI: 10.3760/cma.j.issn.0412-4081.2009.03.004.
18. Berrocal MH, Acaba LA, Chenworth ML. Surgical innovations in the treatment of diabetic macular edema and diabetic retinopathy[J]. Curr Diab Rep, 2019, 19(10): 106. DOI: 10.1007/s11892-019-1210-x.
19. Hagenau F, Vogt D, Ziada J, et al. Vitrectomy for diabetic macular edema: optical coherence tomography criteria and pathology of the vitreomacular interface[J]. Am J Ophthalmol, 2019, 200: 34-46. DOI: 10.1016/j.ajo.2018.12.004.
20. Stolba U, Binder S, Gruber D, et al. Vitrectomy for persistent diffuse diabetic macular edema[J]. Am J Ophthalmol, 2005, 140(2): 295-301. DOI: 10.1016/j.ajo.2005.03.045.
21. Jackson TL, Nicod E, Angelis A, et al. Pars plana vitrctomy for diabetic macular eddema: a systematic review, meta-analysis, and synthesis of safety literature[J]. Retina, 2017, 37(5): 886-895. DOI: 10.1097/IAE.0000000000001280.
22. Simunovic MP, Hunyor AP, Ho IV. Vitrectomy for diabetic macular edema: a systematic review and meta-analysis[J]. Can J Ophthalmol, 2014, 49(2): 188-195. DOI: 10.1016/j.jcjo.2013.11.012.
23. Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control[J]. Diabetes Care, 2009, 32(6): 1119-1131. DOI: 10.2337/dc09-9029.
24. Crabtree GS, Chang JS. Management of complications and vision loss from proliferative diabetic retinopathy[J]. Curr Diab Rep, 2021, 21(9): 33. DOI: 10.1007/s11892-021-01396-2.
25. Wang DY, Zhao XY, Zhang WF, et al. Perioperative anti-vascular endothelial growth factor agents treatment in patients undergoing vitrectomy for complicated proliferative diabetic retinopathy: a network meta-analysis[J/OL]. Sci Rep, 2020, 10(1): 18880[2020-11-03]. https://pubmed.ncbi.nlm.nih.gov/33144606/. DOI: 10.1038/s41598-020-75896-8.
26. Tan Y, Fukutomi A, Sun MT, et al. Anti-VEGF crunch syndrome in proliferative diabetic retinopathy: a review[J]. Surv Ophthalmol, 2021, 66(6): 926-932. DOI: 10.1016/j.survophthal.2021.03.001.
27. El-Sabagh HA, Abdelghaffar W, Labib AM, et al. Preoperative intravitreal bevacizumab use as an adjuvant to diabetic vitrectomy: histopathologic findings and clinical implications[J]. Ophthalmology, 2011, 118(4): 636-641. DOI: 10.1016/j.ophtha.2010.08.038.
28. Van Geest RJ, Lesnik-Oberstein SY, Tan HS, et al. A shift in the balance of vascular endothelial growth factor and connective tissue growth factor by bevacizumab causes the angiofibrotic switch in proliferative diabetic retinopathy[J]. Br J Ophthalmol, 2012, 96(4): 587-590. DOI: 10.1136/bjophthalmol-2011-301005.
29. Smith JM, Steel DH. Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy[J/OL]. Cochrane Database Syst Rev, 2015, 2015(8): CD008214[2015-08-07]. https://pubmed.ncbi.nlm.nih.gov/26250103/. DOI: 10.1002/14651858.CD008214.pub3.
30. Jiang T, Gu J, Zhang P, et al. The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study[J]. BMC Ophthalmol, 2020, 20(1): 43. DOI: 10.1186/s12886-020-1321-9.
31. Tang J, Kern TS. Inflammation in diabetic retinopathy[J]. Prog Retin Eye Res, 2011, 30(5): 343-358. DOI: 10.1016/j.preteyeres.2011.05.002.
32. Das A, McGuire PG, Rangasamy S. Diabetic macular edema: pathophysiology and novel therapeutic targets[J]. Ophthalmology, 2015, 122(7): 1375-1394. DOI: 10.1016/j.ophtha.2015.03.024.
33. Iglicki M, Zur D, Busch C, et al. Progression of diabetic retinopathy severity after treatment with dexamethasone implant: a 24-month cohort study the 'DR-Pro-DEX Study'[J]. Acta Diabetol, 2018, 55(6): 541-547. DOI: 10.1007/s00592-018-1117-z.
34. Wykoff CC, Chakravarthy U, Campochiaro PA, et al. Long-term effects of intravitreal 0.19 mg fluocinolone acetonide implant on progression and regression of diabetic retinopathy[J]. Ophthalmology, 2017, 124(4): 440-449. DOI: 10.1016/j.ophtha.2016.11.034.
35. Iglicki M, Zur D, Fung A, et al. Tractional diabetic retinal detachment surgery with co-adjuvant intravitreal dexamethasone implant: the tradition study[J]. Acta Diabetol, 2019, 56(10): 1141-1147. DOI: 10.1007/s00592-019-01357-y.
36. Wong TY, Sun J, Kawasaki R, et al. Guidelines on diabetic eye care: the international council of ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings[J]. Ophthalmology, 2018, 125(10): 1608-1622. DOI: 10.1016/j.ophtha.2018.04.007.
37. 中华医学会眼科学分会白内障及人工晶状体学组. 中国糖尿病患者白内障围手术期管理策略专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.Cataract and Intraocular Lens Group of Ophthalmology Branch of Chinese Medical Association. Expert consensus on perioperative management strategies for cataract in diabetic patients in China (2020)[J]. Chin J Ophthalmol, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.
38. Peterson SR, Silva PA, Murtha TJ, et al. Cataract surgery in patients with diabetes: management strategies[J]. Semin Ophthalmol, 2018, 33(1): 75-82. DOI: 10.1080/08820538.2017.1353817.
39. Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology[J]. Am J Ophthalmol, 2003, 135(3): 291-296. DOI: 10.1016/s0002-9394(02)01972-4.
40. Schiff WM, Barile GR, Hwang JC, et al. Diabetic vitrectomy: influence of lens status upon anatomic and visual outcomes[J]. Ophthalmology, 2007, 114(3): 544-550. DOI: 10.1016/j.ophtha.2006.08.017.

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The era of minimally invasive vitreous surgery: new insights into diabetic retinopathy surgery

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